With 85% annual average sunshine in southern Arizona, skin cancer is relevant year-round. Last month dermatologist and fellowship-trained Mohs surgeon Jason DuPont, MD, discussed the basics of skin cancer at the Democratic Club of Quail Creek meeting.
“There are actually about 100 different types of skin cancer because the skin is a complex organ with many different types of cells; however, 99% of skin cancers are made up of the main three types: basal cell carcinoma, squamous cell carcinoma and melanoma.
Basal cell carcinoma (BCC) is by far the most common, making up 75 to 80% of skin cancers. Basal cells are often pink in color and can have a pearly, translucent appearance. They usually show up in sun-exposed areas, especially areas that are prone to sunburn. They tend to grow slowly, and while they can be locally destructive, they almost never metastasize. Patients often complain of a “sore that won’t heal.”
Squamous cell carcinoma (SCC) is often due to chronic sun exposure (getting too tanned) mostly found on the hands, forearms and face-—including the lips and ears. SCCs often have a scaly appearance and occasionally can metastasize to lymph nodes and other organs; this is a skin cancer that certainly needs to be treated without delay.
Melanoma is a serious skin cancer that must be treated with surgical excision. There are 60,000 new yearly diagnoses in the U.S. and about 9,000 Americans die each year from metastatic disease. Melanoma is very treatable if found early and fortunately, dermatologists have done a good job of educating the public over the years and most melanomas are in fact detected early. Melanomas have a strong relationship with excessive sun exposure, especially bad sunburns in childhood, but there is also a genetic component and they can run in families as well.
Here are the ABCDE Warning Signs of Melanoma:
A=Asymmetry—-one half does not look like the other half
B=Border Irregularity-—an irregular, scalloped-, or poorly defined border
C=Color Variations—-often black or dark brown-, and often with variation from one area to another
D=Diameter—-greater than 6mm (the size of a pencil eraser)-
E=Evolving—-any skin lesion that is changing: getting bigger, rising up, changing shape, color-, or texture.
“As dermatologists and dermatologic surgeons we have many different methods to treat skin cancer. Melanomas must be excised (cut out) with wide margins, but with basal cell and squamous cell there are several options: we can use destructive techniques (curettage or cryotherapy), topical therapy, injections, excisions, radiation or Mohs surgery.”
Mohs surgery is a specialty within dermatology where a microscope is used to immediately check the deep and peripheral margins of an excision. The Mohs surgeon acts as both the pathologist and reconstructive surgeon-—offering the highest possible cure rate while removing as little of the surrounding normal skin as possible. “We generally use Mohs when aesthetic and functional outcomes are important, thus most of our work is done for skin cancers occurring on the face. Most of the time I’m able to clear a skin cancer in one or two stages, so most of our Mohs patients are in and out the door in less than two hours.”
Dr. DuPont works with Associated Dermatologists in Green Valley and Tucson and is also the Chief of Mohs Surgery at the Tucson VA and an Assistant Clinical Professor of Dermatology with University of Arizona. “We’re very happy to be able to offer this service in Green Valley.”
As parting words of wisdom he added: “Don’t be afraid to get outdoors and enjoy your lives, whether golfing, hiking or playing pickleball. Just remember to be Sun Smart by avoiding sunburns, excessive tanning and sun exposure during the peak hours 9:00 a.m. to 3:00 p.m. Wear a hat and protective clothing, apply sunscreen liberally and see your dermatologist on a regular basis.”
Visit http://www.qcdemocrats.org/ for this article and photos of the three skin cancer types and a Mohs surgery incision vs. a traditional incision.